A Spatial Analysis of Childhood Mortality in West Africa

Infant and child mortality in Africa is higher than in any other continent (see Fig. 1). In particular, West African countries experience mortality two to three times higher than neighbouring countries in northern or in much of southern Africa. Still, there is considerable heterogeneity within the region. For example, Niger’s infant mortality rate is more than double that of Ghana. Subnationally, even when mapped at a coarse resolution, rates differ by as much as a factor of four (see Fig. 2). The countries also show different trends in levels and age patterns of childhood mortality. Furthermore, while it appears that some countries have experienced significant declines in recent mortality (e.g. Niger), others appear to have experienced a reversal in a long-term downward trend (e.g. Burkina Faso). Due to the inherent complexities associated with analysing trends from crosssectional data, this report will focus on major determinants of mortality in the ten years prior to 1997–2001. Its contribution is a consideration of a broad class of spatial covariates. Several individual and household-level factors have been identified as key determinants of infant and child survival. These include maternal education (Trussell and Hammerslough, 1983; Rao et al., 1997; Root, 1997; McMurray, 1997; Agha, 2000) and the pace of childbearing (Boerma and Bicego, 1992; Rao et al., 1997; Root, 1997; Agha, 2000; Gupta and Baghel, 1999; Whitworth and Stephenson, 2002). Many studies indicate that environmental or geographical factors also play an important role. These include, for example, population density (Root, 1997), climate (Ronsmans, 1995; Curtis and Hossain, 1998; Patz et al., 2000; Pitt and Sigle, POPULATION, SPACE AND PLACE Popul. Space Place 10, 175–216 (2004) Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/psp.328